Management of ipsilateral intrapulmonary metastases in the new TNM system for non-small cell lung cancer

Backgrounds. Recently, the Union Internationale Contre le Cancer and Americ an Joint Committee on Cancer reclassified not only TNM staging but also ips ilateral intrapulmonary metastases (PM) as T4 in a same lobe or M1 in diffe rent lobes. To determine whether the new PM staging is appropriate, we stud ied the prognosis of PM. Methods. From January 1981 to October 1997, we performed a lobectomy or pne umonectomy with mediastinal lymph node dissection, and had 42 patients with PM, We analyzed the postoperative prognosis of the patients with ipsilater al PM compared with the same stage group without PM (the non-PM). Results, In the previous classification of PM (the old PM), 2 patients were categorized as stage IIA, 9 as IIB, 17 as IIIA, and 14 as IIIB. After recl assification (the new PM), 37 patients were categorized as stage IIIB, and 5 as IV. The old PM stage IIIA group had a significantly poor prognosis com pared with the non-PM stage IIIA, However, the prognosis of the new PM grou p was compatible with that of the non-PM. None of the other staging group h ad a significant difference in the prognosis. Conclusions. The management of PM in the new TNM system for non-small cell lung cancer is appropriate.